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I wrote about WakeMed's Mothers' Milk Bank yesterday. I featured local mom Maria Sealey, who spoke about her experience donating breast milk to the bank, which distributes it to sick infants.

Sealey pumps and handles the milk that she donates in the exact same way that she pumps and handles the milk for her own daughter.

So, since we were on the subject of pumping breast milk, I thought I'd check in with Nancy Murray, nurse clinician and lactation consultant at Duke Children's Primary Care, which is part of Duke Medicine, Go Ask Mom's sponsor.

She works with nursing moms on a daily basis, offering tips and advice on technique and other issues like pumping.

In an email interview with Go Ask Mom, Murray answered some common questions about pumping. Here are her answers:

Go Ask Mom: When should a nursing mom start pumping and offering her newborn a bottle of expressed breast milk? Should nursing moms worry about "nipple confusion?"

Murray: There is no right time to begin pumping and offering a bottle. Many resources recommend starting or not starting a bottle at different ages, but these are opinions. Each family needs to decide based on their specific situation. In the first weeks, if the baby is feeding well at the breast and gaining well, moms only need to pump to reduce their breast fullness, or if they need to give milk by bottle for a supplement. I recommend that moms feel comfortable with the baby latching, and get their supply established before offering a bottle for convenience. In most cases, babies are able to alternate between breast and bottle feeding without problems.

GAM: There are all kinds of ways to pump - from hospital grade pumps to pumps you can buy at the store to hand expression. What do you recommend for home use?

Murray: I would recommend the least expensive and easiest form of pumping that works for the mom and baby. Some moms are able to hand express easily, or pump a good volume with a manual pump. Other moms need a stronger electric pump. Some of this may depend the mom's experience, milk volume and milk flow.

GAM: When is the best time to pump during the day? After a nursing session, in place of a nursing session?

Murray: If you are trying to accumulate milk for a bottle to offer later, it's best to pump just after the feeding, to pump what is left over. Pumping an hour or more after the feeding is not recommended, as that is refill time for the breasts, and you are taking away milk for the next feeding. If someone else is giving a bottle to your baby at feeding time, then you can pump at that time in place of nursing.

GAM: How much milk should you expect to pump? Does it change over the course of nursing your baby?

Murray: The amount of milk that a mother is able to express depends on many factors including her overall supply, the time of day, as well as her health, fatigue and stress. As the baby's feeding needs change, the amount of pumped milk varies. Babies go through growth spurts that may cause the milk volume to go up. At other times, when mom is tired or stressed, the pump volume may be lower. As a baby grows and gets stronger, her body makes more milk to meet his needs, and pump volumes might rise.

GAM: About how long should a pumping session last?

Murray: After breastfeeding is established, after the first few weeks, mothers usually find that it takes around 20 minutes, pumping both breasts simultaneously, to mostly empty the breasts. If pumping after feeding, ten to fifteen minutes is usually sufficient. Some moms will "letdown" several times during a pumping session, and know the amount of time that this takes. I find that mothers need to "get used" to the pump - as they use it more and become more relaxed, the milk flow improves.

GAM: How long does pumped milk last in the refrigerator? How about the freezer?

Murray: For a healthy, full-term baby breast milk may be stored in the back of the refrigerator for up to 8 days. It can be stored in regular refrigerator freezer for 3-6 months and in a deep freezer for 6-12 months. You should not put fresh milk onto frozen milk. Fresh milk is preferred, but freeze your milk if you are not going to use it within eight days of pumping.

brassyJul 24, 2012

The best time to pump is in the morning. There are (hopefully) fewer feedings during the night and the milk accumulates. I used a double electric pump, but my understanding is that hospital grade pumps are best.

marcellarellaJul 24, 2012

I would also recommend freezing small portions in breast milk storage bags. And freeze them flat. They take less time to thaw out if you freeze them flat.

aztecthecatJul 24, 2012

My son was born at 32 weeks so I was sent home with a hospital pump and expressed my milk to deliver it to the hospital everyday. When he got out of the NICU I continued to pump. I pumped exclusively until he was 13 months. When my daughter was born I knew that I would exclusively pump again. I had so much milk I was able to provide enough for my daughter and my niece (five weeks apart) until they were both 12 months old. It was not easy exclusively pumping especially since I also worked but I would not have had it any other way. I loved the fact that they were getting the best nutrition even if it was not straight from the breast.

-Enter Screen Name-Jul 24, 2012

Here's a tip that I came up with for those moms that are freezing their milk. When my wife started pumping, and we started to have excess milk, I bought a few insulated bags (slightly larger than lunch bags) for the freezer. This did 3 things for us:

1. It kept all of the milk together (instead of getting lost in the freezer).2. It helped to prevent any issues with the freezer being opened/closed regularly (freezer burn, thawing, etc) because the bags were insulated.3. It helped us to keep the milk organized. We'd fill one insulated bag with bags of milk while we used milk from the 'oldest' bag. This kept a good rotation going so that we didn't lose any milk by it getting lost in a big stack and getting too old.

And now that our daughter is past breastmilk, we use the insulated bags as snack totes for when we're out. :-)